Inflammatory Bowel Disease

Front 1

Of the two diseases, which is generally symptomatically worse: Crohn's or Ulcerative Colitis?

Back 1

Crohn's: It involves all three layers of the intestinal mucosa and can occur anywhere along the digestive tract from the mouth to the anus.

Front 2

What is a cardinal sign of Crohn's disease?

Back 2

A skin tag on the anus.

Front 3

Inflammatory bowel disease is thought to be caused by what three factors?

Back 3

1. Genetics/Inherited

2. Immune system dysfunction

3. Environmental factors

Front 4

True or False: Crohn's is easily curable.

Back 4

False: Surgery, diet and medication can help with symptoms, but there is no cure for Crohn's.

Front 5

Why is Ulcerative colitis generally less severe than Crohn's?

Back 5

Ulcerative colitis affects the colon only whereas Crohn's involves the entire GI tract. Ulcerative colitis affects only the inner lining of the GI mucosa while Crohn's affects all three layers.

Front 6

Which condition is more likely to require surgery? A patient with Crohn's or Ulcerative Colitis.

Back 6

Crohn's: In addition, Crohn's patients are more likely to require repeated surgeries.

Front 7

Inflammatory Bowel Disease is a term which includes what two diseases?

Back 7

Ulcerative Colitis and Crohn's.

Front 8

When/how long should the nurse expect to administer antibiotics to a patient who will undergo surgery for IBD?

Back 8

Antibiotics should be administered one hour before the surgery and discontinued 24 hours after the surgery (unless there is a special circumstance for which the antibiotics are needed).

Front 9

Fistulas are more likely to develop in which disease: Crohn's or Ulcerative Colitis?

Back 9

Crohn's: Because the disease involves all three layers of the GI mucosa.

Front 10

There is a higher need for a colectomy among Ulcerative Colitis patients if which medication is not prescribed?

Back 10

High-dose corticosteriods.

Front 11

The Crohn's patient asks the nurse to explain the benefit of a strictureplasty. The nurse knows that the best answer would be...

Back 11

This type of surgery relieves symptoms by removing a very small portion of the bowel. Bowel length is not drastically changed, meaning the patient will have fewer problems with malnutrition and diarrhea.

Front 12

What is the goal of surgery for and IBD patient?

Back 12

To improve quality of life.

Front 13

How do the benefits of surgery differ for the patient with Crohn's and the patient with Ulcerative Colitis?

Back 13

Ulcerative Colitis: removing the colon generally results in a long-term improvement in quality of life.

Crohn's: Removal of the affected bowel may reduce symptoms temporarily, but other portions of the bowel may become affected later causing a relapse in symptoms.

Front 14

What assessments can the nurse perform to monitor for sepsis in the post-operative period?

Back 14

Assess for vitals for low blood pressure and fever. Assess capillary refill time.

Front 15

Pouchitis is a common complication for the ulcerative colitis patient who had a colectomy. What signs of pouchitis can the nurse monitor for?

Back 15

Fever, abdominal cramping, diarrhea, and malaise.

Front 16

List three things IBD patients should be encouraged to do in order to reduce flare-ups?

Back 16

Avoid smoking, eat a low-residue (low-fiber) diet, and manage stress.

Front 17

What is a common issue for patients with IBD?

Back 17

Depression and/or social withdrawal.

Front 18

The nurse should monitor for signs of a bowel obstruction, especially in the post-operative period. What are some common signs?

Back 18

Fever, vomitting, pain

Front 19

Malnutrition is common with IBD patients. Some signs of his include:

Back 19

Anemia, weight loss, hypoalbuminemia, and fatigue. Low levels of Vitamins A, D, and B12. Deficiencies in selenium, iron, zinc and folic acid.

Front 20

Preoperatively, list three things the nurse should do.

Back 20

Obtain consent, answer the patient's surgery questions, bowel prep, discuss pain management, administer antibiotics, advocate for parenteral or enteral nutrition (if needed). Full list on p. 911 of article.

Front 21

Intraoperatively, list three things the nurse should do.

Back 21

Position patient properly, monitor IV antibiotics, monitor vital signs, ensure sterile technique, use compression devices to prevent clots (if needed). Full list on p. 911 of article.

Front 22

Postoperatively, list three things the nurse should do.

Back 22

Manage patient pain, encourage movement, monitor for sepsis and bowel obstruction, monitor I&O, monitor lab values. Full list on p. 911 of article.

Front 23

When should the ostomy nurse be consulted?

Back 23

Before the surgery in order to determine the best placement for the ostomy.

Front 24

What is a common age range for diagnosis of IBD?

Back 24

15-35 years old.

Front 25

Which of the following is not a sign/symptom of IBD? Weight loss, frequent diarrhea, eye and joint irritation, occasional vomiting, delayed growth.

Back 25

Occasional vomiting. Full list on p. 909 of article.